Who is restricted by 19AA?
All Non-Vocationally Registered Australian Citizens or Permanent Residents are restricted by 19AA.
This means if you are born in Australia, have become an Australian Citizen or hold Permanent Residency you will be restricted until you achieve Fellowship with either ACRRM or RACGP, and are recognised as a Specialist in General Practice.
From 2022, all General Practitioners who are hoping to achieve Fellowship with ACRRM or RACGP will be required to join a 3GA Training program to be eligible to sit the Fellowship exams.
What does it mean to be restricted by 19AA?
If you are restricted by 19AA, you are required to join a 3GA program to gain access to Medicare benefits.
As soon as you receive Permanent Residency (from 5pm the day you become a Permanent Resident) you will need to cease practice until you are on an approved 3GA program.
If you are restricted by 19AA and not on a 3GA program, you will not be granted access to Medicare Benefits. Medicare can issue a fine if they discover you have continued to claim Medicare Benefits without being on a 3GA Program. You will also be required to return 100% of the money you billed to Medicare.
What if I just don’t want to join a 3GA program?
If for some reason you don’t want to join a 3GA program, you are still able to practice, you just won’t be able to provide services that offer a Medicare rebate through Medicare. Therefore, your patients, even if they have Medicare and are eligible to be bulk-billed, will have to pay the full cost of the appointment out of pocket and will not receive a rebate.
What are the options for 3GA programs?
Your 3GA program options will depend on if you meet the eligibility criteria and on your practice location, if relevant. We have put together a summary of all the 3GA programs below:
The ACRRM Independent Pathway is a 4 year Specialist training program that assists GPs on the pathway towards ACRRM Fellowship and Specialist Registration.
If you hold General Registration, Provisional Registration or Area of Need Limited Registration and have completed 1 year of postgraduate hospital experience in Australia or in an approved Competent Authority you will be eligible for the program.
You will be required to find a practice that is in a MMM 2-7 location to work in. Please note that 12 months must be completed in a MMM 4-7 area.
Applications are open various times in the year and are listed in the key dates calendar on their website. If applications are not open when you apply, you can submit an expression of interest to be notified when applications next open.
The ACRRM Independent Pathway does have a substantial fee ($24,950), so you will need to be prepared to cover these costs if you plan to join.
There is a grant available via the Non-Vocationally Registered Fellowship Support Program (Non-VR FSP) which offers up to $15,000* of Commonwealth support to achieve Fellowship on the Independent Pathway.
The Rural Generalist Training Scheme (RGTS) is a fully funded program of the College-led Independent Pathway, which leads to Fellowship of ACRRM (FACRRM). It offers a thorough Rural Generalist education program, a flexible training environment, opportunities to meet program criteria, and individualised training support.
This is a four year program broken into three years of Core General Training (CGT), and one year of Advanced Specialist Training (AST).
To be eligible for this training scheme, you need to be a permanent resident or Australian citizen, hold a general AHPRA registration, and have a job offer or be currently working in a MMM 2-7 location, as stated in their website.
Please note that the ACRRM Supervisor and Training Post Standards Handbook specified the provision of clinical experience in CGT. The accepted domains are primary care, secondary care, emergency care, and rural or remote practice (MMM 4-7 or MMM3 and provide relevant experience).
The ACRRM runs two intakes per year. You can apply via their website. You need to pay a $700 application fee, an ongoing ACRRM membership fee of $430 per year, as well as fellowship assessments.
AGPT is a 3 – 4 year training program for registrars on the journey to either RACGP or ACRRM Fellowship and Specialist Registration as a General Practitioner.
There are 2 different pathways available for GPs and these depend on your 19AB restriction. If you are restricted by 19AB you will join the Rural Pathway with AGPT. GPs in this pathway will undertake all of their training in rural areas that fulfil their 19AB restrictions.
The General Pathway of the AGPT program is for GPs that are not restricted by 19AB. GPs on this pathway will work in inner and/or outer metropolitan areas.
If you have a 19AB exemption specifically for AGPT, such as a spousal exemption, you are eligible to join the General Pathway instead of the Rural Pathway. You will need to hold the exemption prior to applying for AGPT.
You aren’t able to choose a specific practice to work in on this program, but you can nominate your preferred area regions. Once you have been accepted for a region, you will be provided with a list of practices to contact to try to join.
Applications for AGPT generally open in April and August each year and you can apply through their website.
To be eligible you need to currently hold General Registration, or you will hold General Registration with AHPRA prior to the commencement of the program. You must also be a Permanent Resident or Australian Citizen.
AGPT offers a great level of support for participants, clinics are thoroughly vetted and contracts are negotiated for you.
Australian Government funding for the AGPT Program covers the cost of your training.
You will have to pay your own application fees, assessment fees, and college membership costs.
RVTS is a Fellowship training program for registrars on the journey to either RACGP or ACRRM Fellowship, designed to provide educational opportunities for GPs in rural areas with limited education opportunities.
RVTS provides training via distance education and remote supervision, so this allows GPs working in remote communities’ access to support whilst providing highly needed medical services.
You can apply to RVTS through either the Remote Stream or AMS Stream. To apply through the Remote Stream, you need to be practicing as a GP in an MMM 4 – 7 classification area. To apply through the AMS Stream, you need to be working as a GP in an Aboriginal Community Controlled Health Service with an MMM Classification of 2 – 7.
To apply, you must hold either General Registration, Provisional Registration or Limited Registration. If you have Provisional/Limited Registration, you will be required to have level 3 or 4 supervision
You will need to be working in the practice at the time of applying and remain in the same practice throughout the program. You can apply to RVTS if you are an Australian Citizen, if you hold Permanent Residency and if you are a Temporary Resident.
Training with RVTS is funded by the Commonwealth.
FSP is the new self-funded education and training program that replaces the Practice Experience Program (PEP) Standard Stream. This program reinforces RACGP’s objective of supporting doctors who aspire to complete their Fellowship via the General Practice Experience (GPE) Pathway.
To participate in FSP you will need to hold a general or limited medical registration (Level 2 supervision and above only) enabling full scope of practice, be employed or have a job offer in a practice in an MMM 2-7 location at the time of application, pass the assessment exam and pay the fees.
If you pass the entrance exams for FSP, you will have the opportunity to apply for a new Medical Provider Number that is at the A1 level. As per the Medicare Benefits Schedule (MBS) A1 level is equivalent to consultation fee bracket being charged by VR General Practitioners.
To be eligible for a FSP Provider Number (if it is required), you must work in a training location that complies with the General Practice Fellowship Program Placement Guidelines. This means FSP is particularly made for GPs whose placements are in MM2-7 areas. If you wish to join FSP but are employed in an MM1 area, it will be subject to approval of exceptional circumstances.
Additionally, you must have a minimum of one exam semester remaining to complete all Fellowship examinations, as per the Fellowship Exam Attempts Policy. You may have multiple attempts to the AKT and KFP exams. However, you need to pass the exams in your fifth semester and dedicate your sixth and final semester to your clinical exams. For the cost of the program, you may refer to this page.
Recently, we received an update that you may be able to apply to have your Recognition of Prior Learning (RPL) assessed in certain circumstances. Depending on how this assessment goes, your time in the program could be reduced by six months (from 24 to 18 months). You can apply for RPL after the first six months of your program.
MDRAP is a 3GA program that has been created to encourage more doctors to work in rural and remote communities.
To be eligible for the program you need to hold current AHPRA Registration, have a job offer in an eligible location and have the necessary skills and experience to perform the role. If you do not have previous General Practice experience, you can still apply for MDRAP. You will just need to have a Supervisor in the Practice that is willing to assist you in this transition.
As part of this program you will need to find a practice in a DPA area with a MMM Classification between 2 – 7. All Aboriginal Medical Services are eligible regardless of location criteria.
This program allows GPs 2 years on the program before they will need to transition to an alternative 3GA Program. Whilst on the program, you are expected to submit 1 application for either AGPT, ACRRM Independent Pathway, RVTS or FSP every year, as well as complete foundation general practice training modules provided by either the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine within six months of commencing on the MDRAP. If you are on MDRAP for more than 12 months, at least half of your annual professional development activities must be relevant to general practice.
Applications for MDRAP are open throughout the year and you can apply for this program by emailing the Rural Workforce Agency in your State or Territory. The application process depends on the state. Applications take around 28 business days to process.
Whilst MDRAP fulfils your 19AA requirements, it is not a fellowship training program and after 2022 you will need to transfer to AGPT, ACRRM Independent Pathway, RVTS or FSP in order to sit the Fellowship exams.
There are no costs associated with MDRAP.
This program allows you to gain clinical experience during the after-hour periods.
AMDS services can either be clinic based or involve visiting patients’ homes and these practices are available in both metropolitan and regional areas.
Your eligible working hours are between 6pm to 8am on weekdays, before 8am and from noon onwards on Saturday, all-day Sunday and on Public Holidays.
As your patient base is restricted, your experience will be assessed at 50% if visiting patients outside of the clinic and 75% if managing patients in clinic. Additionally, this time will be capped at 2.5 years assessed.
You can apply for AMDS at any time through an AMDS accredited practice after you have received a job offer. The practice will need to be accredited through AMDS – a practice that operates in the after-hours but is not accredited with AMDS will not be accepted in an application. Essentially, all AMDS clinics are after hours, but not all after hours clinics are AMDS. So make sure you check!
If you have Limited or Provisional AHPRA Registration, you will only be able to join AMDS in an in-clinic position and will need to meet the Supervision Requirements of AHPRA.
Whilst AMDS fulfils your 19AA requirements, it is not a fellowship training program and after 2022 you will need to transfer to AGPT, ACRRM Independent Pathway, RVTS or FSP in order to sit the Fellowship exams.
There is no cost associated with AMDS.
Note: The information presented above has been gathered from AHPRA, RACGP, and ACRRM web pages and has been updated as of 05.07.2023.
- ACRRM Independent Pathway
- ACRRM Rural Generalist Training Scheme (RGTS)
- Australian General Practice Training (AGPT) Program
- Remote Vocational Training Scheme (RVTS)
- RACGP Fellowship Support Program (FSP)
- RACGP Fellowship Support Program (FSP) Application handbook
- More Doctors for Rural Australia Program guidelines
- Approved Medical Deputising Services (AMDS) program
- 2022 Applicant Guide Remote Stream – Round 4
- 2022 Applicant Guide AMS Stream – Round 4
- ACRRM Supervisor and Training Post Standards Handbook
How Can We Help You?
Our team offers General Practitioners assistance with finding jobs and a career pathway, and Medical Facilities to find a new Medical Practitioner. We also help with the full application process with AHPRA, RACGP, ACRRM, Department of Health, Medicare including 19AA & 19AB. If we can help, please contact us at email@example.com.
People Medical Consulting are a team of professionals with a passion for guiding those specialising in the Medical industry to find their career pathway and settle into Australia. Working with both Australian trained and Overseas trained professionals, we have extensive experience in Recruitment of General Practitioners and Document Assistance for those requiring support with RACGP, AHPRA, 19AA and 19AB Medicare Exemptions.